MADISON NOELLE PEDLAR – Physical Therapist, NPI 1033094628

MADISON NOELLE PEDLAR is a healthcare provider. based in Traverse city, Michigan. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold a License No. 5501303598 (MI). The NPI Number for MADISON NOELLE PEDLAR is 1033094628

Main info

Female
1 Year Of Experience
Accepts Medicare Assignment
Name
MADISON NOELLE PEDLAR
NPI
1033094628
Phone
(231) 935-0900
Address
4045 W ROYAL DR
Enumeration Date
11 August 2025
Last Update Date
11 August 2025

Doctor Profile

Medical School Name
CENTRAL MICHIGAN COLLEGE OF MEDICINE
Secondary Phone
2319350900
Graduation Year
2025 (1 year ago)
PAC ID
2567965130
Group Practice PAC ID
1759371826
Professional Enrollment ID
I20250910002729
Address ID
MI496848965TR4045XDRXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience24
Completeness85
Years active:0State licenses:1Digital endpointsOther names

3,459 PHYSICAL THERAPIST IN PRIVATE PRACTICE in MI

Provider Addresses for MADISON NOELLE PEDLAR

  • 4045 W ROYAL DR

    TRAVERSE CITY, MI 496848965

    Phone: (231) 935-0900

    Fax: (231) 935-0312

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-09-10

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250910002729IPhysical Therapist In Private PracticeMITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 49684)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1759371826View full group profile
NameSpecialtyState
Physician AssistantMI
Orthopedic SurgeryMI
Physician AssistantIA
Orthopedic SurgeryMI
Orthopedic SurgeryMI
Orthopedic SurgeryMI
-MI
Orthopedic SurgeryWV
Nurse PractitionerUT
Orthopedic SurgeryUT

Reviews

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Frequently asked questions

Does MADISON NOELLE PEDLAR share an NPI with anyone else?
NPI numbers are unique to each provider or organization — MADISON NOELLE PEDLAR uses 1033094628.
Is MADISON NOELLE PEDLAR listed as active for patients and plans?
The listing shows MADISON NOELLE PEDLAR as active in the NPI system.
What is MADISON NOELLE PEDLAR's primary classification?
Physical Therapist is the headline specialty for MADISON NOELLE PEDLAR here. Clinical services aligned with this taxonomy classification.
What address line appears for MADISON NOELLE PEDLAR?
MADISON NOELLE PEDLAR's geographic hint is Traverse City, Michigan in our summary view.
Why does MADISON NOELLE PEDLAR have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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